ABSTRACT Introduction The ability to adapt dynamic balance to perturbations during gait deteriorates with age. To prevent age-related decline in adaptive control of dynamic balance, we must first understand how adaptive control of dynamic balance changes across the adult lifespan. We examined how adaptive control of the margin of stability (MoS) changes across the lifespan during perturbed and unperturbed walking on the split-belt treadmill. Methods Seventy-five healthy adults (age range, 18–80 yr) walked on an instrumented split-belt treadmill with and without split-belts. Linear regression analyses were performed for the mediolateral (ML) and anteroposterior (AP) MoS, step length, single support time, step width, double support time, and cadence during unperturbed and perturbed walking (split-belt perturbation), with age as predictor. Results Age did not significantly affect dynamic balance during unperturbed walking. However, during perturbed walking, the ML MoS of the leg on the slow belt increased across the lifespan due to a decrease in bilateral single support time. The AP MoS did not change with aging despite a decrease in step length. Double support time decreased and cadence increased across the lifespan when adapting to split-belt walking. Age did not affect step width. Conclusions Aging affects the adaptive control of dynamic balance during perturbed but not unperturbed treadmill walking with controlled walking speed. The ML MoS increased across the lifespan, whereas bilateral single support times decreased. The lack of aging effects on unperturbed walking suggests that participants’ balance should be challenged to assess aging effects during gait. The decrease in double support time and increase in cadence suggests that older adults use the increased cadence as a balance control strategy during challenging locomotor tasks.
The common paradigm to study the adaptability of human gait is split-belt walking. Short-term savings (minutes to days) of split-belt adaptation have been widely studied to gain knowledge in locomotor learning but reports on long-term savings are limited. Here, we studied whether after a prolonged inter-exposure interval (three weeks), the newly acquired locomotor pattern is subject to forgetting or that the pattern is saved in long-term locomotor memory. Can savings of adaptation to split-belt walking remain after a prolonged inter-exposure interval of three weeks? Fourteen healthy adults participated in a single ten-minute adaptation session to split-belt walking and five-minute washout to tied-belt walking. They received no training after the first exposure and returned to the laboratory exactly three weeks later for the second exposure. To identify the adaptation trends and quantify saving parameters we used Singular Spectrum Analysis, a non-parametric, data-driven approach. We identified trends in step length asymmetry and double support asymmetry, and calculated the adaptation volume (reduction in asymmetry over the course of adaptation), and the plateau time (time required for the trend to level off). At the second exposure after three weeks, we found substantial savings in adaptation for step length asymmetry volume (61.6–67.6% decrease) and plateau time (76.3 % decrease). No differences were found during washout or in double support asymmetry. This study shows that able-bodied individuals retain savings of split-belt adaptation over a three-week period, which indicates that only naïve split-belt walkers should be included in split-belt adaptation studies, as previous experience to split-belt walking will not be washed out, even after a prolonged period. In future research, these results can be compared with long-term savings in patient groups, to gain insight into factors underlying (un)successful gait training in rehabilitation.
Control of dynamic balance in human walking is essential to remain stable and can be parameterized by the margins of stability. While frontal and sagittal plane margins of stability are often studied in parallel, they may covary, where increased stability in one plane could lead to decreased stability in the other. Hypothetically, this negative covariation may lead to critically low lateral stability during step lengthening.Is there a relationship between frontal and sagittal plane margins of stability in able-bodied humans, during normal walking and imposed step lengthening?Fifteen able-bodied adults walked on an instrumented treadmill in a normal walking and a step lengthening condition. During step lengthening, stepping targets were projected onto the treadmill in front of the participant to impose longer step lengths. Covariation between frontal and sagittal plane margins of stability was assessed with linear mixed-effects models for normal walking and step lengthening separately.We found a negative covariation between frontal and sagittal plane margins of stability during normal walking, but not during step lengthening.These results indicate that while a decrease in anterior instability may lead to a decrease in lateral stability during normal walking, able-bodied humans can prevent lateral instability due to this covariation in critical situations, such as step lengthening. These findings improve our understanding of adaptive dynamic balance control during walking in able-bodied humans and may be utilized in further research on gait stability in pathological and aging populations.
Abstract Background Most people with Parkinson’s Disease (PD) walk with a smaller mediolateral base of support (BoS) compared to healthy people, but the underlying mechanisms remain unknown. According to the extrapolated center of mass (XCoM) concept, a decrease in mediolateral XCoM excursion would require a smaller mediolateral BoS to maintain a constant margin of stability (MoS) and remain stable. As people with PD typically walk with reduced trunk motion, we hypothesized that the mediolateral MoS might stay the same despite a smaller BoS. Research question As proof of principle, we assess whether walking with reduced trunk motion results in a smaller step width in healthy adults, without altering the mediolateral MoS. Methods Fifteen healthy adults walked on a treadmill at preferred comfortable walking speed in two conditions. First, the ‘regular walking’ condition without any instructions, and second, the ‘reduced trunk motion’ condition with the instruction: ‘Keep your trunk as still as possible’. Treadmill speed was kept the same in the two conditions. Trunk kinematics, step width, mediolateral XCoM excursion and mediolateral MoS were calculated and compared between the two conditions. Results Walking with the instruction to keep the trunk still significantly reduced trunk kinematics. Walking with reduced trunk motion resulted in significant decreases in step width and mediolateral XCoM excursion, but not in the mediolateral MoS. Furthermore, step width and mediolateral XCoM excursion were strongly correlated during both conditions (r=0.887 and r=0.934). Significance This study shows that walking with reduced trunk motion leads to a gait pattern with a smaller BoS in healthy adults, without altering the mediolateral MoS. Our findings indicate a strong coupling between CoM motion state and the mediolateral BoS. We expect that people with PD who walk narrow-based, have a similar mediolateral MoS as healthy people, which will be further investigated.